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Combination Therapy Harmful in Patients With Type 2 Diabetes

by Staff


US Pharm. 2011;36(9):HS-39-HS-40. 

Patients with type 2 diabetes facing a higher cardiovascular disease risk often take a combination of medications designed to lower their LDL cholesterol and triglyceride levels while raising their HDL cholesterol. Doctors have long believed that taken together, the drugs offer protection from heart attacks and improve survival. 

In a recent commentary in the New England Journal of Medicine, however, doctors who served on a recent FDA panel that evaluated the drugs' effectiveness say the commonly prescribed medications, called fibrates, have not been proven successful at preventing heart attacks in patients with type 2 diabetes with elevated cholesterol. 

“There have been few studies regarding the clinical outcome efficacy of fibrates,” said Sanjay Kaul, MD, a commentary author and director of the Cardiology Fellowship Training Program at the Cedars-Sinai Heart Institute.  

“Thousands and thousands of Americans take fibrates every day but so far, there are no long-term studies showing that fibrates lower cardiovascular risk or improve survival among diabetes patients who are also on statins.” The authors suggest that doctors prescribe the statin-fibrate combination only to diabetic patients at high risk for a heart attack and only after optimal control of LDL cholesterol has been achieved with statin treatment.
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